# KEIKI CLUB HOUSE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760141816
- **Authorized official:** DR. CATHERINE LONG LMFT, ED.D., LMFT (ADMINISTRATOR-THERAPIST)
- **Authorized official phone:** (808) 298-6555

## Contact information

- **Practice address:** 4504 KUKUI ST, KAPAA, HI 96746-1701
- **Practice address phone:** (808) 298-6555
- **Mailing address:** PO BOX 510232, KEALIA, HI 96751-0232
- **Mailing address phone:** (808) 298-6555
- **Mailing address fax:** (808) 320-8057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2021
- **Last updated:** 12/15/2021